1989 Volume 35 Issue 1 Pages 249-257
Thirteen cases of branchial cysts were investigated clinically and histopathologically.
The mean age was 30.2 years and the highest incidence was recognized in the second and third decades. The sex distribution showed female predominance. The upper and middle neck were the more common sites, but 3 cases in parotid gland and one in submental region were also found. The chief complaint was painless swelling. Most cases were rather easily diagnosed clinically, but the cases of parotid gland tended to be diagnosed as benign tumors. Extirpations or superficial parotidectomies were performed and neither reccurrences nor complications were observed during postoperative period. The size of the cysts was 60mm×40mm in the largest case and 20mm×15mm in the smallest. One cyst had two daughter cysts. The contents were mostly either mucous, muddy or creamy, but those of 3 cases were serous, 2 of which occurred in parotid gland. The biochemical analysis of conten revealed high activity of amylase and especially the salivary type of amylase isozyme in some cases.
Histopathologically the following findings were obtained. The epithelium of all the cysts of neck was of stratified squamous cell type. Cuboidal cell type was found in 2 of three cases occurring in parotid gland. The lymphnoid tissue beneath the epithelium was varied in both quality and quantity. The salivary tissue was found beneath the epithelium in all three cases of parotid gland. One case had the histological characteristics of both dermoid cyst and lymphoepithelial cyst.
Consequently the variety of clinical and histopathological characteristics as described above suggested the possibility of the multiple origins of branchial cyst.